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Published October 1, 2010 | Published
Journal Article Open

The role of stereotactic radiosurgery in the multimodal management of growth hormone–secreting pituitary adenomas


Growth hormone (GH)–secreting pituitary adenomas represent a common source of GH excess in patients with acromegaly. Whereas surgical extirpation of the culprit lesion is considered first-line treatment, as many as 19% of patients develop recurrent symptoms due to regrowth of previously resected adenomatous tissue or to continued growth of the surgically inaccessible tumor. Although medical therapies that suppress GH production can be effective in the management of primary and recurrent acromegaly, these therapies are not curative, and lifelong treatment is required for hormonal control. Stereotactic radiosurgery has emerged as an effective adjunctive treatment modality, and is an appealing alternative to conventional fractionated radiation therapy. The authors reviewed the growing body of literature concerning the role of radiosurgical procedures in the treatment armamentarium of acromegaly, and identified more than 1350 patients across 45 case series. In this review, the authors report that radiosurgery offers true hormonal normalization in 17% to 82% of patients and tumor growth control in 37% to 100% of cases across all series, while minimizing adverse complications. As a result, stereotactic radiosurgery represents a safe and effective treatment option in the multimodal management of primary or recurrent acromegaly secondary to GH-secreting pituitary adenomas.

Additional Information

© 2010 American Association of Neurosurgeons. Manuscript submitted June 14, 2010. Accepted July 14, 2010. Author contributions to the study and manuscript preparation include the following. Conception and design: Weiss, Stapleton. Acquisition of data: Stapleton. Analysis and interpretation of data: Stapleton. Drafting the article: Stapleton. Critically revising the article: all authors. Reviewed final version of the manuscript and approved it for submission: all authors.

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